Duque-Dizon, Grace
Duque-Dizon, Grace is an individual health care provider with primary practice located at 3356 Vineville Ave , Macon GA 31204-2328. She recently has only one registered license in Allopathic & Osteopathic Physicians / Interventional Pain Medicine, which is considered as her primary health care specialty. Duque-Dizon, Grace can be contacted via phone (478) 476-9642.Contact Information
Primary practice address
3356 Vineville Ave
Macon GA 31204-2328
Phone: (478) 476-9642
Fax: (478) 476-9976
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Interventional Pain Medicine | 208VP0014X | 019935 | Georgia |
Profile Details
| NPI number | 1306823034 |
|---|---|
| LBN Legal business name | Duque-Dizon, Grace |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 22nd, 2005 |
| Last updated | Nov 30th, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306823034 | NPPES |
| Georgia | MEDICAID | 000412244K |
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